Neck and SpInal Cord InfectIons

What Are Spinal Infections?

Spinal infections are microbial diseases that affect the spine, caused by various types of bacteria or fungi. These infections can occur after spine surgery or may develop spontaneously in patients who have certain risk factors, such as a weakened immune system or chronic disease.

How Do Spinal Infections Develop?

Spinal infections typically start when bacteria or fungi reach the spine through the bloodstream or by direct contamination, especially after surgical procedures. The infection first causes inflammation in the affected area. Over time, it begins to spread to the intervertebral disc and vertebral bones, damaging the spinal structure.

In advanced cases, the infection may penetrate the posterior wall of the spine, enter the spinal canal, and put pressure on the spinal cord and nerves. This can lead to spinal collapse and fractures in the affected vertebrae.

Symptoms of Spinal Infections

The symptoms of a spinal infection can vary from mild to severe and may include:

• Fever and chills
• Weakness and fatigue
• Severe back or neck pain
• Headache and neck stiffness
• Swelling, redness, and tenderness at the surgical wound site
• Discharge from the wound
• Numbness in the arms or legs
• Loss of sensation or muscle strength

In some patients, these symptoms may develop gradually, while in others, the condition can present with a sudden and acute clinical picture.

How Are Spinal Infections Diagnosed?

Diagnosis begins with a detailed medical history and physical examination by a specialist. To confirm the diagnosis, the doctor may order the following tests:

• Imaging tests such as X-rays, CT scans, MRI, or scintigraphy
• Blood tests including complete blood count, biochemistry, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR)

These diagnostic tools help determine the presence and severity of the infection and guide appropriate treatment.

Non-Surgical Treatment of Spinal Infections

Conservative treatment options are used in early-stage or mild spinal infections. These include:

• Antibiotic therapy for bacterial infections
• Anti-tuberculosis treatment for tuberculosis-related infections
• Antifungal medications for fungal infections

These treatments aim to eliminate the infection and prevent further damage to spinal tissues.

Surgical Treatment Options for Spinal Infections

In more advanced cases or when conservative treatment fails, surgical intervention becomes necessary. The surgical approach depends on factors such as:

• Type and location of the infection
• Size of the abscess
• Extent of tissue and bone damage
• The patient’s overall health and immune status

Surgical procedures may involve:

• Abscess evacuation and tissue debridement (cleaning of infected tissues)
• Use of cages or spinal instrumentation to replace damaged vertebrae
• Placement of surgical drains
• Negative pressure wound therapy (woundvac) for continuous drainage and wound healing

After surgery, close follow-up and long-term antimicrobial treatment are essential for a successful recovery and prevention of recurrence.